Does Time for (in)Direct Nursing Care Activities at the End of Life for Patients With or Without Specialized Palliative Care in a University Hospital Differ? A Retrospective Analysis.

Fliedner, Monika C.; Hagemann, Monika; Eychmüller, Steffen; King, Cynthia; Lohrmann, Christa; Halfens, Ruud J G; Schols, Jos M G A (2020). Does Time for (in)Direct Nursing Care Activities at the End of Life for Patients With or Without Specialized Palliative Care in a University Hospital Differ? A Retrospective Analysis. The American journal of hospice and palliative care, 37(10), pp. 844-852. Sage 10.1177/1049909120905779

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BACKGROUND

Nurses' end of life (EoL) care focuses on direct (eg, physical) and indirect (e,g, coordination) care. Little is known about how much time nurses actually devote to these activities and if activities change due to support by specialized palliative care (SPC) in hospitalized patients.

AIMS

(1) Comparing care time for EoL patients receiving SPC to usual palliative care (UPC);(2) Comparing time spent for direct/indirect care in the SPC group before and after SPC.

METHODS

Retrospective observational study; nursing care time for EoL patients based on tacs® data using nonparametric and parametric tests. The Swiss data method tacs measures (in)direct nursing care time for monitoring and cost analyses.

RESULTS

Analysis of tacs® data (UPC, n = 642; SPC, n = 104) during hospitalization before death in 2015. Overall, SPC patients had higher tacs® than UPC patients by 40 direct (95% confidence interval [CI]: 5.7-75, P = .023) and 14 indirect tacs® (95% CI: 6.0-23, P < .001). No difference for tacs® by day, as SPC patients were treated for a longer time (mean number of days 7.2 vs 16, P < .001).Subanalysis for SPC patients showed increased direct care time on the day of and after SPC (P < .001), whereas indirect care time increased only on the day of SPC.

CONCLUSIONS

This study gives insight into nurses' time for (in)direct care activities with/without SPC before death. The higher (in)direct nursing care time in SPC patients compared to UPC may reflect higher complexity. Consensus-based measurements to monitor nurses' care activities may be helpful for benchmarking or reimbursement analysis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Fliedner, Monika and Eychmüller, Steffen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1938-2715

Publisher:

Sage

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

22 Apr 2020 14:47

Last Modified:

01 Aug 2020 01:31

Publisher DOI:

10.1177/1049909120905779

PubMed ID:

32180430

Uncontrolled Keywords:

comparative retrospective study direct nursing care activities end-of-life care health service research indirect nursing care activities specialized palliative care intervention usual palliative care intervention

BORIS DOI:

10.7892/boris.143024

URI:

https://boris.unibe.ch/id/eprint/143024

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